<div class="col-lg-12 wrapperbox">
	 			<form class="form-horizontal" role="form">	  
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">单位名称</label>
						    <div class="col-sm-10">
                                 <input type="text" class="form-control" id="tbunitname" placeholder="单位名称">         
						    </div>
						  </div>
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">单位地址</label>
						    <div class="col-sm-10">
                                 <input type="text" class="form-control" id="tbaddress" placeholder="单位地址">         
						    </div>
						  </div>
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">联系人</label>
						    <div class="col-sm-10">
						     <input type="text" class="form-control" id="tbcontact" placeholder="联系人">
						    </div>
						  </div>
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">联系电话</label>
						    <div class="col-sm-10">
						     <input type="text" class="form-control" id="tbtel" placeholder="联系电话">
						    </div>
						  </div>
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">供货品类</label>
						    <div class="col-sm-10">
						     	<select class="form-control">
                                    <option>猪肉</option>
                                    <option>牛肉</option>
                                    <option>白菜</option>
                                    <option>蒜苗</option>
                                    <option>小葱</option>
                                </select>
						    </div>
						  </div>
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">结算户名</label>
						    <div class="col-sm-10">
						     <input type="text" class="form-control" id="tbusername" placeholder="结算户名">
						    </div>
						  </div>
						  <div class="form-group">
						    <label for="" class="col-sm-2 control-label">结算银行</label>
						    <div class="col-sm-10">
						     <input type="text" class="form-control" id="tbbank" placeholder="结算银行">
						    </div>
						  </div>
						   <div class="form-group">
						    <label for="" class="col-sm-2 control-label">结算账号</label>
						    <div class="col-sm-10">
						     <input type="text" class="form-control" id="tbbanknum" placeholder="结算账号">
						    </div>
						  </div>
					</form> 		
                </div>